Is Intermittent Fasting Safe For People With Diabetes?
When the now 46-year-old Mary Roberts from Lockhart, Texas, was diagnosed with type 2 diabetes in 2008, her doctor immediately put her on Metformin (glucophage), a drug to help stabilize blood sugar. “When I got the diagnosis, I guess I wasn’t surprised,” says Roberts, explaining that not only was she overweight but her mom had been on insulin for type 2 diabetes. Not wanting to be on medication herself for her entire life, Roberts set out on a path to control the diabetes through diet, but a few years of nutrition classes proved unsuccessful in lowering her blood sugar level. It was after her doctor suggested insulin on top of the high dose of Metformin that Roberts switched gears. “I really wanted to find a way to get healthy,” she says. She found the solution in changing her approach to eating — just not the way she expected. Intermittent fasting (IF) combined with the popular ketogenic diet, which emphasizes dramatically reducing carbohydrate intake, helped her lose weight and lower her A1C. “I feel amazing,” Roberts says. What Is Intermittent Fasting and How Is It Done? Although IF has become more popular in recent years, the diet plan isn’t new. In fact, many religions (including Christianity, Judaism, and Islam) have followers who practice fasting of some variety throughout the year. Fasting is often required for blood tests, medical procedures, or surgery. The reason IF has gained so much attention recently is likely due to the release of new diet books plugging the plans and celebrity endorsements. “I think that it has gained popularity because anytime a person drastically cuts calories from their diet, they’re going to lose weight. And we’re so results driven that by seeing that happen we think, This is a great solution,” says Despina Continue reading >>
How Intermittent Fasting Can Help Reverse Diabetes
The “Fast Cure” for Diabetes Though we may not like to admit it, type 2 diabetes is a disease chiefly brought on by our lifestyle choices.[1] Yes, genetics come into play too, but when it comes to type 2 diabetes, you are not a slave to your gene pool. You have the power to even alter your genes.[2] According to the American Diabetes Association, type 2 diabetes is increasing worldwide at an alarming rate due to obesity and a sedentary lifestyle.[3] So, let’s say that you (or someone you know) became overweight, were less and less active, and finally one day at a routine doctor visit, your doctor announced that you have type 2 diabetes and put you on medication to lower your blood sugar. Perhaps you’ve been taking diabetes meds for years now and the idea of reversing your diabetes seems far-fetched, even fanciful. Maybe your doctor doesn’t believe that type 2 diabetes is reversible. That has been the traditional medical thought greatly influenced by the pharmaceutical companies who want to push their expensive drugs. But a new day has dawned and many doctors are seeing their patients reverse their type 2 diabetes. One effective way people reverse their type 2 diabetes is by intermittent fasting. Dr. Jason Fung, MD, writes, “While many consider type 2 diabetes (T2D) irreversible, fasting has been long known to cure diabetes.”[4] Wow, “cure” is a strong word coupled with diabetes and spoken by a medical doctor! Harvard University is home to the famous Joslin Center for Diabetes. The center is named after Dr. Elliot Joslin, one of the greatest specialists in diabetes of all time. In 1916, Dr. Joslin wrote an article in the Canadian Medical Association Journal about fasting for the treatment of diabetes. Based on his experience, he was convinced that all i Continue reading >>
Introduction To Intermittent Fasting
Editor’s Note: Cyrus Khambatta, PhD, lives with type 1 diabetes and coaches his clients in a non-traditional nutritional approach to diabetes management. The views expressed in this article are his own. Intermittent fasting is term coined by the research world that refers to an extended duration of minimal calorie intake. Believe it or not, humans are evolutionarily adapted to performing intermittent fasts – our ancestors performed extended fasts whenever food was unavailable, and feasted only when they could procure enough food to eat. However, in our modern world of abundance, deliberately fasting for an extended period of time is anything but “normal.” Fasting goes against every morsel of modern life, and is in direct opposition to the abundance-based food culture that we have worked so hard to create. In our world of fast food, on-demand food delivery and 24-hour convenience stores, choosing not to eat food can seem strange indeed. I spent my entire graduate career investigating the effects of intermittent fasting in rodents, in order to understand why calorie restriction and intermittent fasting are the gold standards for improving insulin sensitivity. As a result of this active body of research, tens of thousands of people across the world engage in intermittent fasting on a weekly basis, as a means of improving their body composition, losing fat mass, shedding pounds or observing a religious holiday. The research world has taken a large interest in calorie restriction and intermittent fasting, for the explicit purpose of identifying cellular mechanisms that may retard the aging process and promote excellent metabolic health. And in the process of studying intermittent fasting, researchers have uncovered a laundry list of health benefits that confuse even Continue reading >>
Intermittent Fasting, Cortisol And Blood Sugar
There’s been a lot of discussion about the benefits of intermittent fasting (IF) in the paleo community lately. Paul Jaminet mentions it’s role in boosting the immune system in his book, The Perfect Health Diet, and IF can also be helpful for those trying to lose weight and tune their metabolism. From an evolutionary perspective, intermittent fasting was probably the normal state of affairs. There were no grocery stores, restaurants or convenience stores, and food was not nearly as readily available or easy to come by as it is today. Nor were there watches, schedules, lunch breaks or the kind of structure and routine we have in the modern world. This means it’s likely that our paleo ancestors often did go 12-16 hours between meals on a regular basis, and perhaps had full days when they ate lightly or didn’t eat at all. So, while I agree that IF is part of our heritage, and that it can be helpful in certain situations, I don’t believe it’s an appropriate strategy for everyone. Why? Because fasting can elevate cortisol levels. One of cortisol’s effects is that it raises blood sugar. So, in someone with blood sugar regulation issues, fasting can actually make them worse. I’ve seen this time and time again with my patients. Almost all of my patients have blood sugar imbalances. And it’s usually not as simple as “high blood sugar” or “low blood sugar”. They often have a combination of both (reactive hypoglycemia), or strange blood sugar patterns that, on the surface, don’t make much sense. These folks aren’t eating a Standard American Diet. Most of them are already on a paleo-type or low-carb diet. Yet they still have blood sugar issues. In these cases, cortisol dysregulation is almost always the culprit. When these patients try intermittent fas Continue reading >>
Intermittent Fasting: Not So Fast
I’m sure that at least a few of you have heard or read about the latest trend in weight loss called “intermittent fasting.” The very word “fasting” is probably less than appealing, as it pretty much means you don’t eat or drink anything (except perhaps water) for a specified amount of time. Starvation is not exactly recommended among health professionals. But intermittent fasting is different. Is it something you should try? What is intermittent fasting, anyway? Intermittent fasting has been the talk of the town, so to speak, thanks to two recent books to hit the market: The Fast Diet by Dr. Michael Mosley and Mimi Spencer, and The Overnight Diet by Caroline Apovian, MD. Intermittent fasting essentially means that you skip a meal or severely restrict calories on certain days of the week with the intention of losing weight, controlling blood glucose, and/or decreasing heart disease risk. But on the other days of the week, you can pretty much eat what you want (within reason, of course). For many people, this concept sounds appealing. Limiting calories for a couple days a week doesn’t sound that bad if you can eat what you want the rest of the time. The Fast Diet, also called the The 5:2 Diet has you eat between 500 and 600 calories (women get 500 calories, men get 600 calories) for two days out of the week, spread over two meals of about 250 to 300 calories. These fast days should not be right in a row, and your food choices ideally should be more plant-based and emphasize protein. The premise is that after several hours of fasting, the body burns up its carbohydrate stores and shifts to burning fat for fuel. Many claim that intermittent fasting also helps to blunt appetite. The Overnight Diet emphasizes getting enough sleep; a lack of sleep can disrupt met Continue reading >>
Strategies For Management Of Intermittent Fasting In Patients With Diabetes
Islam is the second most common religion in the world, and there are 1.6 billion Muslims, many in areas where diabetes is prevalent. Each year observant Muslims fast during the daylight hours for the holy month of Ramadan. It is estimated that 50 million diabetic people fast between dawn and sundown during Ramadan, and Muslims are not the only group of patients who fast for religious or other reasons. It is important for healthcare providers to guide patients with diabetes in avoiding problems related to prolonged fasting. In this issue of the Cleveland Clinic Journal of Medicine, Drs. A.V. and Zagar address management of diabetes specifically relating to Ramadan fasting, with considerations that also apply to other diabetic patients who fast for religious or for medical reasons. Fortunately, we now have antihyperglycemic agents that are unlikely to cause hypoglycemia if used alone or in combination, as long as the regimen does not include insulin or a sulfonylurea. These include: Metformin and thiazolidinediones (pioglitazone and rosiglitazone), which improve insulin sensitivity Glucagon-like peptide 1 (GLP-1) agonists (exenatide, liraglutide, dulaglutide, and albaglutide), which facilitate insulin release in a glucose-dependent fashion Dipeptidyl peptidase 4 inhibitors (sitagliptin, saxagliptin, alogliptin, and linagliptin), which augment endogenous incretin hormones, primarily GLP-1, and also facilitate insulin production in a glucose-dependent fashion Alpha glucosidase inhibitors (acarbose and miglitol), which slow carbohydrate absorption. Introduced in recent years, the sodium-glucose cotransporter 2 (SGLT-2) inhibitors canagliflozin, dapagliflozin, and empagliflozin lower blood glucose by reducing the renal threshold for reabsorption of glucose, coupled with reabs Continue reading >>
Intermittent Fasting Could Help Tackle Diabetes – Here’s The Science
Intermittent fasting is currently all the rage. But don’t be fooled: it’s much more than just the latest fad. Recent studies of this kind of fasting – with restricted eating part of the time, but not all of the time – have produced a number of successes, but the latest involving diabetes might be the most impressive yet. The idea of intermittent fasting arose after scientists were wowed by the effects of constant calorie restriction. A number of studies in many different animals have shown that restricted eating throughout adulthood leads to dramatic improvements in lifespan and general health. The reasons for these improvements aren’t yet clear. Part of it seems to be that going without food gives cells in the body a much needed break to perform maintenance and repair. But the lack of food also forces cells to resort to alternative sources of energy. Some of these, such as ketones – molecules created in the liver from recycled fat – appear to be beneficial. ‘Fasting’ without fasting The problem is that constant calorie restriction isn’t practical: it’s easy for scientists to impose upon lab animals, but hard for humans to impose upon themselves in the real world. Fortunately, we’ve learned that constant calorie restriction isn’t really necessary. Intermittent fasting seems to have many of the same benefits. There are two main types of intermittent fasting. One type, known as “time restricted feeding”, requires eating only during a few hours of the day – say between 10am and 6pm. This approach gives the body a long break from food each night, and also reinforces beneficial circadian rhythms. The other type of intermittent fasting – made popular by the 5:2 diet – is known as “periodic fasting”. This approach involves alternating be Continue reading >>
Intermittent Fasting – Questions & Answers
Here you can find common questions about intermittent fasting with answers from our top expert, Dr. Jason Fung. Choose a topic below or scroll down for every question and answer. Do you have other questions about fasting for Dr. Jason Fung? Watch our in-depth interview with him or ask him directly on our membership site (free trial). You can also visit Dr. Fung’s website IDMprogram.com. Who can use intermittent fasting? Is fasting an option for children who need to lose weight? Fasting is not an option for children. My advice is to severely restrict added sugars and snacking. Reducing down to 2 meals per day is also possible, but not longer duration fasting. My daughter who is 31 and a healthy weight exercises (rowing) four times a week. She wants to know if she can fast or is this not recommended for people who exercise? Not only is it safe, but training in the fasted state has several theoretical benefits that many elite level athletes are using. So, yes, it is highly recommended. Can women fast during pregnancy and after birth during breast feeding? I don’t advise fasting during pregnancy or breast feeding. Short term (<24 hrs) fasts are OK, but definitely not longer term fasts. There is a concern of nutrient deficiency which I think far outweighs any potential benefit. How should intermittent fasting be used in conjunction with resistance training to maximize muscle growth and fat burning? Should there be any differences between intermittent fasting on training days and non-training days? And during the fasting periods – or days – is it advisable to take supplements such as BCAA’s to prevent muscle loss? There are many different schedules. Most people fast for 24 hrs and then do their training – this is called ‘training in the fasted state’. Since gr Continue reading >>
5:2 Fasting Diet
Tweet The 5:2 intermittent fasting (IF) diet, more commonly referred to simply as the 5:2 diet, has become one of the more popular diet plan in recent years. Studies have shown that the diet helps with weight loss and may also reduce insulin resistance, both of which are of particular interest for many people with type 2 diabetes or borderline diabetes. One reason for the popularity of the diet is that it allows a certain amount of flexibility, in comparison to low calorie diets, on most days of the week. Theory behind the diet The idea of the diet is that short periods of fasting prompt the body to repair damage but not enter a starvation mode of conserving energy. Whilst the theory has yet to be conclusively proved, clinical studies have shown promising results for the diet, however it has only been examined over relatively short time spans, of less than a year. How the 5:2 diet works The 5:2 intermittent fasting diet is based on a simple idea. 5 days a week you stick to meeting the daily calorie intake advised for people of a healthy weight, that being: 2,500 kcal per day for men 2,000 kcal per day for women For the other 2 days each week, the diet stipulates that you have only around 25% of the values above, which is equal to: 600 kcal on these days for men 500 kcal on these days for women The fasting days can be taken at any time during the week as long as you do not take 2 fasting days consecutively. Benefits of the 5:2 diet Clinical studies have shown that the benefits of intermittent fasting are largely similar to those of a calorie restricted diets. The most commonly reported benefits among people from following the 5:2 diet: Research has shown that periods of fasting can help to improve life expectancy and decrease risks of diseases including nerve disorders, Continue reading >>
Fasting Cures Type 2 Diabetes – T2d 4
While many consider Type 2 Diabetes (T2D) irreversible, fasting has also been long known to cure diabetes. In our previous post, we considered bariatric surgery. While extreme, these surgeries have proven the point that the metabolic abnormalities that underlie T2D (hyper insulinemia, insulin resistance) can often be fully reversed after a short (weeks) period of intensive treatment with bariatrics. Many early studies were done with the heavy-duty Roux-en-Y surgery, which is the heavyweight champions of surgeries. The best weight loss. The most complications. This is the surgery that has ‘Go Big or Go Home’ tattooed on its massive bicep. But even milder forms of bariatric surgery show the same reversibility of T2D. A gastric band is essentially a belt implanted around your stomach. They keep tightening the belt so that you can’t eat. If you try to eat too much, you’ll puke it all back up. Loverly. It ain’t pretty, but it sure do work. Again, long term results are kind of iffy, but short term results are pretty good. You can see the results of gastric banding versus medical treatment from the graph above. Patients randomized to the gastric band showed a significant and pretty damn good drop in their fasting blood sugars. In other words, T2D was reversing in a b-i-g way. Those given medicines alone didn’t do very well at all. Basically they stayed the same. They were no better than before. So, yes, even gastric banding these 500 pound patients with 20 years of diabesity can reverse within weeks even before the weight comes off. One of the main questions is why? There are many hypotheses – which we will consider in a later post, but it is the sudden severe restriction of all calories that causes this beneficial effect. This is the same thing as the time teste Continue reading >>
Caveman Fasting Diet May Leave Women Diabetic
Its promise to melt away pounds with minimal pain is seductive and, unlike so many fad diets, comes with promises of extraordinary health benefits. Just like the Atkins, cabbage soup and blood group diets before it, however, the latest flavour of the month weight loss regime could leave a bad taste in the mouth. The few studies which confirm its benefits also reveal a potentially dangerous divide. Intermittent fasting is very effective for men but potentially dangerous for many women. There is increasing evidence that women are less likely to lose weight and more prone to unpleasant side effects such as insomnia, impaired fertility and increased stress hormones. According to Michael Moseley, the doctor turned-television presenter who popularised this new approach to weight loss, the proof is in the pudding (which remains on the menu for five out of seven days). After trying the feast-and-famine regime for five weeks for the BBC documentary Eat, Fast and Live Longer, he lost almost a stone and reduced his body fat, cholesterol and blood sugar. He also halved his levels of IGF-1, an insulin-like growth factor, which increases the risk of cancer. However Dr Catherine Collins, Chief Dietician at London’s St George’s Hospital, warns that basic differences in biology make it effective for men, but unsuitable for many women. For starters, men have a higher percentage of muscle, which gives them a faster metabolism, so if a man and woman of comparable size restrict their intake to 800 calories a day the man will lose more weight. Their greater muscle mass also protects men from some of the downsides of the diet. Dr Collins explains: “The average adult turns over 300grams of protein a day. Eighty per cent of that is recycled, broken down and reused; a bit like Lego bricks, Continue reading >>
Fasting Diet 'regenerates Diabetic Organ'
The pancreas can be triggered to regenerate itself through a type of fasting diet, say US researchers. Restoring the function of the organ - which helps control blood sugar levels - reversed symptoms of diabetes in animal experiments. The study, published in the journal Cell, says the diet reboots the body. Experts said the findings were "potentially very exciting" as they could become a new treatment for the disease. People are advised not to try this without medical advice. In the experiments, mice were put on a modified form of the "fasting-mimicking diet". It is like the human form of the diet when people spend five days on a low-calorie, low-protein, low-carbohydrate but high unsaturated-fat diet. It resembles a vegan diet with nuts and soups, but with around 800 to 1,100 calories a day. Then they have 25 days eating what they want - so overall it mimics periods of feast and famine. Previous research has suggested it can slow the pace of ageing. Diabetes therapy? But animal experiments showed the diet regenerated a special type of cell in the pancreas called a beta cell. These are the cells that detect sugar in the blood and release the hormone insulin if it gets too high. Dr Valter Longo, from the University of Southern California, said: "Our conclusion is that by pushing the mice into an extreme state and then bringing them back - by starving them and then feeding them again - the cells in the pancreas are triggered to use some kind of developmental reprogramming that rebuilds the part of the organ that's no longer functioning." There were benefits in both type 1 and type 2 diabetes in the mouse experiments. Type 1 is caused by the immune system destroying beta cells and type 2 is largely caused by lifestyle and the body no longer responding to insulin. Further t Continue reading >>
The Fascinating Relationship Between Intermittent Fasting And Diabetes
Weight management and Type 2 diabetes Weight loss and weight management are very closely linked to diabetic health and treatment. Besides genetic factors, obesity is the most significant reason for Type 2 diabetes as it interferes with the body’s ability to use insulin to properly regulate blood sugar levels. This explains why weight management is the most recommended strategy for the treatment of type 2 diabetes. Losing weight helps Type 2 diabetes patients reduce their insulin resistance and enhances their body’s ability to use insulin better. Moderate and Intermittent Fasting for Diabetes In this context of weight management for diabetics, one of the most effective strategies is the concept of intermittent fasting. This concept turns on its head the vastly popular myth that eating 5-6 small meals during the day is beneficial for diabetic patients. Studies have shown that this practice of spreading out meals over the day may not be ideal for diabetics as it increases the risk of spikes in their blood sugar levels. This practice additionally keeps blood sugar levels high, effectively, doing little to address the underlying cause – the inability of the body to adequately process sugars and maintain glucose levels. This is where intermittent moderate fasting can benefit Type 2 diabetes patients. Clinical studies have shown that intermittent fasting produces the desired results for diabetics- weight loss and a reduction in insulin resistance. Moderate fasting ensures a number of health benefits, including improved insulin sensitivity, lowered triglycerides, weight loss and reduced sugar cravings, all extremely beneficial for diabetes and its management. Intermittent fasting and regulation of insulin levels Fasting is a simple and effective way to force your body to Continue reading >>
How Fasting Reverses Type 2 Diabetes
While many consider type 2 diabetes (T2D) irreversible, fasting has been long known to cure diabetes. In our previous post, we considered bariatric surgery. While extreme, these surgeries have proven the point that the metabolic abnormalities that underlie T2D (hyperinsulinemia, insulin resistance) can be fully reversible even after a few short weeks. Many early studies were done with the heavy-duty Roux-en-Y surgery, which is the heavyweight champions of surgeries. The best weight loss. The most complications. This is the surgery that has ‘Go Big or Go Home’ tattooed on its massive bicep. But even milder forms of bariatric surgery show the same reversibility of T2D. A gastric band is essentially a belt implanted around your stomach. The surgeon keeps tightening the belt so that you can’t eat. If you try to eat too much, you’ll puke it all back up. Lovely. It ain’t pretty, but it sure does work. Again, long term results are kind of iffy, but short term results are pretty good. The results of gastric banding versus medical treatment showed a significant and pretty damn good drop in their fasting blood sugars. In other words, their T2D was reversing in a b-i-g way. Those given medicines alone basically stayed the same. They were no better than before. Gastric banding a 500 pound patient will still reverse 20 years of diabesity within weeks. One of the main questions is why? There are many hypotheses, but essentially, it is the sudden severe restriction of all calories that causes this beneficial effect. This is the same thing as the time tested, ancient healing tradition of fasting. Fasting is the voluntary restriction of food for religious, health or other purposes (eg. hunger strikes). Is bariatrics simply a surgically enforced fast? The short answer is yes. I Continue reading >>
Intermittent Fasting And Its Beneficial Effects On The Body
Dr. Mark Mattson intermittent fasting research: old tradition potentially benefits body’s organs, providing possible cure and treatment. Research and a sit down with Dr. Mark Mattson at the NIH shows intermittent fasting is resurfacing as a medical treatment used in certain comorbidities, rather than medication. So often individuals consume food throughout the day without much energy expenditure, which over time becomes a problem due to the types of unhealthy food consumed, and the amount of food consumed. Hypertension, cardiovascular disease, obesity, and even diabetes become the end result of those behaviors. Fasting could be the new savior to these conditions, with the benefits going through the roof. — Click here to access Dr. Mark Mattson intermittent fasting video series & downloadable transcript – exclusive discussion with Diabetes in Control — Fasting means to eat only small meals, or none at all, for long periods of time. This can be done every day or even one day a month. Different types of intermittent fasting consist of alternate day fasting or ingesting less than 600 calories a day, eating a regular diet five days a week and only 600 calories the remaining two days, and lastly eating all of one’s calories during a 4-8 hour window. These different types of fasting can be tailored to fit each individuals needs and schedules, with the addition of not needing to eat breakfast. Dr. Mattson also debunked the rule of eating three meals a day with a valid point comparing earlier times to now. “There is evidence that the 3 meals/day routine began during the early period of the agricultural revolution when people were working hard on the farms every day. They undoubtedly had a high calorie requirement to support their high energy expenditure (e.g., 4000 � Continue reading >>
